Psychosexual disorders Flashcards
Sexual dysfunction
Regular lack of interest in or pain during sex or problems achieving lubrication/erection/orgasm
Delayed Ejaculation
Marked delay
Infrequency/absence of ejac despite adequate sexual stimulation
Consider- Partner probs, relationship factors, psychiatric comorbidity, culture/religious
Erectile DO
Marked difficulty obtaining erection until completion of sexual activity
Dec rigidity
Assoc= low SE, confidence
Female orgasmic DO
Marked delay/infrequency of/ absence of orgasm
Reduced intensity of orgasms
Female sexual interest/arousal DO
Lack of/reduced sexual interest/arousal= 3 of flwng
Dec interest in Sexual act
Dec sex/erotic thoughts/fantasies
Dec sex excitement dur sex activity
Unresponsiveness to partner’s attempts to initiate
Dec arousal to sex cues
Dec genital/non-genital sensations during sex act
Genito-Pelvic Pain/Penetration DO
Difficulties w/ 1 or more:
Vaginal penetration
Pelvic pain during vag/penetration attempts
Fear/Anx about Vag/pelv in anticipation of penetration
Tension/tightening of pelvic floor during attempted penetration
Male Hypoactive sex desire
Absence of sex thoughts/fantasies/desire for sex
Premature ejac
Ejac occurring w/in 1 min following vag penetration
Or before wanted
Substance/Med Induced Sex Dysfunction
Sx soon after substance use
Alcohol/opioids/S/H, anxiolytics
50% of antipsychotics
Sex dysfunction facts
More common if abuse alcohol/drugs
Also from DM, neuro DO
Psychological Causes of Sex dysfunction
Sexual ignorance Sexual anxiety (perf issue) Psych defenses against erotic feelings Lack of communication Physical factors Drugs MD, guilt Psychosocial issues (trauma)
Clinical Errors
Misinformation (oral sex means germs, simul org is must) Over reaction (anal/bisex) Value judgment (best posit) Inappropriate tx (think better)
Tx
Psychosocial- symptom focused, brief
Couple- superior to relax/desensitization
Sex Therapy- dec anx/restore confid
Tx 2
Indiv/marital therapy (CBT)
Ind/couple relaxation
